ASSESSMENT OF WOMEN’S EXPECTATIONS AND EXPERIENCES DURING CHILDBIRTH AMONG POSTNATAL WOMEN AT UNIVERSITY OF BENIN TEACHING HOSPITAL, BENIN CITY, EDO STATE

Abstract

The study investigated women's childbirth experiences at the University of Benin Teaching Hospital using a quantitative survey research design. A structured questionnaire was developed to gather data from a sample of 120 postnatal women. The questionnaire focused on capturing women's expectations, actual experiences during childbirth, factors influencing satisfaction, and perceptions of healthcare provider support. Data collected were analyzed using descriptive statistics, presented in frequency tables to highlight patterns and trends in respondents' perceptions. Key hypotheses were tested using a t-test, assuming a mean of zero and employing a critical table value of 2.92 at a 5% level of significance. Findings revealed significant differences between women's expectations and their actual experiences during childbirth, highlighting discrepancies that impact overall satisfaction. Moreover, effective communication with healthcare providers emerged as a significant determinant influencing women's satisfaction levels. Adequate support during labor was also found to significantly contribute to women's overall satisfaction with their childbirth experiences. In conclusion, the study underscores the importance of addressing gaps between women's expectations and actual experiences during childbirth to enhance maternal satisfaction and healthcare quality. Recommendations include implementing training programs for healthcare providers to improve communication skills and support practices during labor. Furthermore, enhancing the physical environment of maternity wards to ensure comfort and safety could positively influence women's childbirth experiences. These insights are crucial for healthcare policymakers and providers aiming to optimize maternity care services and improve maternal health outcomes. Overall, the study contributes valuable insights into the dynamics of childbirth experiences at the University of Benin Teaching Hospital, providing a foundation for future research endeavors and policy interventions aimed at enhancing maternal care practices and outcomes.

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Childbirth is a significant event in a woman's life, marked by various physical, emotional, and psychological experiences. The process of giving birth is not just a biological event but a deeply personal journey that profoundly impacts a woman's life. From the anticipation of labor pains to the joy of seeing their newborn, women undergo a spectrum of emotions and expectations during this transformative period (Sarker et al., 2022).

Women's expectations and experiences during childbirth play a crucial role in shaping their overall satisfaction with the birthing process. Research indicates that positive experiences during labor contribute significantly to maternal satisfaction and subsequent maternal health outcomes (Moshi & Nyamhanga, 2021). Factors such as access to skilled birth attendants, supportive care, and respectful treatment during childbirth are pivotal in determining how women perceive their birthing experience and their willingness to seek professional care in future pregnancies (Kumbani et al., 2023).

Understanding these expectations and experiences is essential for improving maternal care. Studies highlight that women value being treated with dignity and respect during childbirth. This includes effective communication, involvement in decision-making processes, and compassionate care from healthcare providers (Hirose et al., 2017). When these aspects are met, women report higher levels of satisfaction and are more likely to adhere to recommended postnatal care practices, thus improving overall maternal health outcomes (Chun Tie et al., 2019).

Enhancing the quality of healthcare services provided to women during the postnatal period requires addressing barriers that hinder access to skilled birth attendance and facility-based deliveries. In many low-resource settings, women face challenges such as distance to health facilities, financial constraints, and cultural preferences for traditional birth attendants (TBAs) (Sarker et al., 2022). Addressing these barriers involves implementing community-based interventions that promote the importance of facility-based deliveries and ensure the availability of skilled birth attendants (Allou, 2018).

The role of traditional birth attendants (TBAs) also influences women's choices regarding childbirth. Despite efforts to promote facility-based deliveries, some women still prefer TBAs due to cultural familiarity and perceived personalized care (Bohren et al., 2017). Understanding these preferences is crucial for developing strategies that bridge the gap between traditional practices and modern healthcare services, thereby improving maternal and neonatal health outcomes (Okafor et al., 2023).

Disrespect and abuse during facility-based childbirth remain significant concerns that impact women's experiences. Studies reveal instances of mistreatment, including verbal abuse, neglect, and physical mistreatment, which deter women from seeking facility-based care (Ishola et al., 2017). Addressing these issues requires comprehensive training for healthcare providers on respectful maternity care practices and the enforcement of policies that protect women's rights during childbirth (Galadanci et al., 2020).

Furthermore, the provision of adequate labor support is essential in enhancing women's childbirth experiences. Labor support encompasses emotional support, comfort measures, and advocacy for women's preferences during labor and delivery (Onasoga et al., 2018). Research shows that women who receive continuous support during childbirth are less likely to request medical interventions and report more positive perceptions of their birthing experiences (Farotimi et al., 2018).

Incorporating a women-centered approach to obstetric care is crucial for improving maternal health outcomes. This approach emphasizes respectful maternity care, informed decision-making, and individualized support tailored to women's needs (Dim et al., 2021). By prioritizing women's preferences and ensuring their active participation in the birthing process, healthcare providers can promote positive childbirth experiences and contribute to better maternal health outcomes overall (Sarker et al., 2022).

In essence, childbirth represents a critical milestone in a woman's life, characterized by a range of expectations and experiences that profoundly impact maternal satisfaction and health outcomes. Enhancing the quality of maternal care requires addressing barriers to facility-based deliveries, promoting respectful maternity care practices, and ensuring women have access to skilled birth attendants. By understanding and meeting women's expectations during childbirth, healthcare systems can foster positive experiences that contribute to improved maternal and neonatal health outcomes globally.

1.2 Statement of Problem

The childbirth experience for women remains a critical aspect of maternal healthcare, yet it is fraught with challenges that impact maternal satisfaction and health outcomes. Despite global efforts to improve maternal care, disparities persist in the quality and accessibility of obstetric services (Moshi & Nyamhanga, 2021). In many low-resource settings, women encounter significant barriers to accessing skilled birth attendants and facility-based deliveries, including geographical distance, financial constraints, and cultural preferences for traditional birth attendants (Kumbani et al., 2023; Sarker et al., 2022).

Moreover, disrespect and abuse during facility-based childbirth are prevalent issues that undermine women's confidence in healthcare systems (Ishola et al., 2017). Instances of mistreatment, such as verbal abuse and neglect, contribute to women's reluctance to seek professional care, thus increasing the risk of adverse maternal and neonatal outcomes (Galadanci et al., 2020).

Furthermore, the preference for traditional birth attendants (TBAs) among some women reflects deep-rooted cultural norms and perceptions of personalized care that challenge efforts to promote facility-based deliveries (Bohren et al., 2017; Okafor et al., 2023). This preference persists despite evidence suggesting higher risks associated with home births attended by TBAs, including limited access to emergency obstetric care (Allou, 2018).

In light of these challenges, there is a pressing need to investigate and address the factors influencing women's childbirth experiences comprehensively. Understanding the complex interplay of socio-cultural factors, healthcare infrastructure, and healthcare provider attitudes is essential for developing effective strategies that promote respectful maternity care and improve maternal health outcomes globally (Dim et al., 2021; Farotimi et al., 2018). Thus, this study aims to explore the multifaceted challenges surrounding women's expectations and experiences during childbirth, with a focus on identifying barriers and proposing solutions to enhance maternal healthcare delivery.

1.3 Objectives of the Study

This study aimed to achieve the following specific objectives:

1. Investigate the expectations of postnatal women regarding childbirth experiences at University of Benin Teaching Hospital, Benin City, Edo State.
2. Examine the actual experiences of postnatal women during childbirth at University of Benin Teaching Hospital, Benin City, Edo State.
3. Analyze the factors influencing women's satisfaction or dissatisfaction with their childbirth experiences at University of Benin Teaching Hospital, Benin City, Edo State.

1.4 Research Questions

To guide the study, the following research questions were formulated:

1. What are the primary expectations of postnatal women regarding their childbirth experiences?
2. What are the actual experiences of postnatal women during childbirth at University of Benin Teaching Hospital?
3. What factors contribute to women's satisfaction or dissatisfaction with their childbirth experiences at University of Benin Teaching Hospital?

1.5 Research Hypotheses

Based on the objectives and research questions, the following hypotheses were formulated:

1. There is no significant difference between women's expectations and their actual experiences during childbirth.
2. Communication with healthcare providers do not significantly influences women's satisfaction with childbirth experiences.
3. Support received during labor does not significantly affects women's overall satisfaction with childbirth experiences.

1.6 Significance of the Study

The significance of this study lies in its potential to contribute valuable insights into improving maternal healthcare practices and outcomes globally. Childbirth is a pivotal event in a woman's life, influencing not only her immediate health but also her long-term well-being and that of her newborn. By focusing on women's expectations and experiences during childbirth, this study addresses several critical areas of significance:

Firstly, understanding women's expectations during childbirth is crucial for tailoring healthcare services to meet their needs effectively. By identifying what women value most in their birthing experience such as respectful treatment, compassionate care, and involvement in decision-making healthcare providers can enhance patient-centered care practices (Hirose et al., 2017). This approach not only improves maternal satisfaction but also promotes better adherence to recommended postnatal care, thereby reducing maternal morbidity and mortality rates (Sarker et al., 2022).

Secondly, the study aims to highlight disparities in access to quality maternal healthcare services. In many regions, socio-economic factors, cultural beliefs, and geographical barriers contribute to inequities in healthcare access for pregnant women (Kumbani et al., 2023). By examining these barriers, the research seeks to advocate for policies and interventions that promote equitable access to skilled birth attendants and facility-based deliveries, especially in underserved communities (Galadanci et al., 2020).

Thirdly, addressing the issue of disrespect and abuse during facility-based childbirth is a critical aspect of this study's significance. Mistreatment during childbirth, including verbal abuse and neglect, not only violates women's rights but also undermines trust in healthcare systems (Ishola et al., 2017). By shedding light on these issues, the study aims to stimulate discussions on improving healthcare provider training, enforcing policies that protect women's rights, and fostering a culture of respectful maternity care (Bohren et al., 2017).

Fourthly, the study seeks to contribute to the body of knowledge on effective strategies for promoting facility-based deliveries over home births attended by traditional birth attendants (TBAs). Despite efforts to promote skilled birth attendance, cultural preferences and perceived benefits of home births persist in many communities (Okafor et al., 2023). By exploring these dynamics, the research aims to inform interventions that bridge cultural practices with modern healthcare approaches, ensuring safer childbirth experiences for women and their infants (Allou, 2018).

Finally, this study's findings are expected to inform policy-makers, healthcare providers, and stakeholders in maternal health about the critical factors influencing women's childbirth experiences. By advocating for evidence-based practices and policies, the research aims to contribute to global efforts aimed at achieving Sustainable Development Goal 3, which targets reducing maternal mortality and improving maternal health outcomes worldwide (Farotimi et al., 2018). Ultimately, the significance of this study lies in its potential to drive positive change in maternal healthcare delivery, ensuring that every woman has access to safe, respectful, and dignified childbirth experiences.

1.7 Scope of the Study

This study focused on assessing women's expectations and experiences during childbirth specifically at University of Benin Teaching Hospital, Benin City, Edo State.

1.8 Operational Definition of Terms

For clarity and consistency, the following terms were operationally defined:

1. Childbirth: The process of giving birth to a child.
2. Expectations: Anticipated desires or outcomes regarding childbirth.
3. Experiences: Actual events and perceptions encountered during childbirth.
4. Satisfaction: Degree of contentment or fulfillment with childbirth experiences.
5. Healthcare Providers: Medical professionals involved in providing maternity care.
6. Support: Emotional, physical, and informational assistance received during labor and delivery.
7. Maternal Health: Physical and mental well-being of women during and after childbirth.
8. Postnatal Period: Time immediately following childbirth up to six weeks.